Fluoride works by hardening tooth structure, preventing bacterial build-up, as well as being anti-microbial.
Adults can have caries too!! On top of that, it is beneficial for prevention of root caries which is almost only seen in adults due to presence of gum disease and gum recession. Root caries are also harder to treat than crown caries, so the best is not to have them.
Fluoride comes in two forms:
Systemic is better since the hardening works to protect the entire tooth, but will only be effective if the tooth is still developing.
Topical is not as good since it is a surface-hardening, but some surface protection is better than none. The topical fluorides applied by the dentist are also a higher concentration, unlike the fluoride in commercial mouthwash and toothpaste.
There are also many factors which will tip the balance towards continual demineralization and sometimes we need technology to try and uncover them.
For our present and new patients who are truly interested and committed to prevention of caries, we use a system called CAMBRA to help them out.